Date: Monday, June 4, 2018
Session Time: 2:30pm-4:00pm
Presentation Time: 3:18pm-3:30pm
Location: Room 2AB
Purpose: The incidence of incisional hernias (IH) requiring operative repair in live kidney donors and abdominal transplant recipients is not well-defined. Therefore, we examined the incidence of incisional hernia repairs (IHR) in this unique population.
Methods: Adult patients who underwent donor nephrectomy or solid organ transplantation at Vanderbilt Medical Center between January 1, 1990, and March 31, 2014, with documented follow-up were included in the study. The incidence of IHR was determined using CPT codes. A logistic regression model was used to determine associations with an increased risk of requiring an IHR.
Results: The study population included 886 liver transplant patients (71% male), 89 pancreas transplant patients (60% male), 1536 kidney transplant patients (61% male), and 771 patients who underwent donor nephrectomy (45% laparoscopic, 36% male). There were 65 liver transplant patients (7%), 5 (6%) pancreas recipients and 36 (2%) kidney transplant recipients that required an IHR. Three patients (1%) who underwent open donor nephrectomy and 19 patients (5%) who underwent laparoscopic donor nephrectomy required an IHR. Post-operative complications (p=0.02) and the need for re-operation in 90 days (p=0.02) were associated with an increased risk of IHR. Compared to kidney transplant patients, liver transplant patients and kidney donors were 3.5 (p=<0.001) and 4.3 (p=<0.001) times more likely to undergo IHR, respectively.
|Effect||Odds ratio||p-value||95% Confidence Interval
(lower bound, upper bound)
|Female (ref: male)||0.69||0.09||(0.44, 1.05)|
|Liver transplant (ref: Kidney transplant)||3.48||<0.001||(2.09, 5.79)|
|Laparoscopic kidney donor (ref: Kidney transplant||4.25||<0.001||(2.19, 8.28)|
|Reoperation (90 days)||1.88||0.02||(1.09, 3.23)|
|Length of stay||1.00||0.85||(0.96, 1.05)|
Conclusion: The incidence of IHR after laparoscopic donor nephrectomy and liver transplantation is clinically significant and targeted preventive efforts at the time of the initial operation should be considered to decrease hernia formation.
CITATION INFORMATION: Kensinger C., Phillips S., Hale D., Shaffer D., Poulose B., Baucom R. Incisional Hernia Repair after Abdominal Solid Organ Transplant and Living Kidney Donation: A Single Institution Experience Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Kensinger C, Phillips S, Hale D, Shaffer D, Poulose B, Baucom R. Incisional Hernia Repair after Abdominal Solid Organ Transplant and Living Kidney Donation: A Single Institution Experience [abstract]. https://atcmeetingabstracts.com/abstract/incisional-hernia-repair-after-abdominal-solid-organ-transplant-and-living-kidney-donation-a-single-institution-experience/. Accessed October 27, 2020.
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